34 Unexplained Infertility and Looking for FET Advice

[Anonymous]

We just got a negative result from our 1st medicated FET after a failed fresh transfer. I took a digital FRER at 8dp5dt which was positive and then two more regular tests which both had fainter lines. Received a negative result today from beta at 14dp - it was around 3. We have two more untested embryos left and I’m trying to decide whether to transfer both and whether to try an unmedicated cycle. Although we are “unexplained”, I suspect endometriosis since I have really bad cramps. We are paying OOP and a patient at CNY in NY (based in DC) so they have us on the kitchen sink protocol which includes prednisone, low-dose Naltrexone, baby aspirin, lovenox. estrogen and progesterone suppositories plus shots. Does anyone have advice on the above or general suggestions to increase success before my next FET? Thank you!

[Anonymous]

I'm really sorry your first cycle failed, especially with the positive test false hope. I think that positive test is a good sign that implantation started, so I would try another unmedicated cycle transfer.

CNY is not as conservative as local clinics and I know it is tempting when you're OOP, but do not transfer both. You are young and it is not crazy to think both remaining embryos could be normal. Twins are dangerous, and even if everyone (you and the babies) get through pregnancy, they are HARD. I know multiple twin moms from transferring two and they've all said they would much rather have had one child at a time. If you had been through half a dozen failed transfers, then maybe, but even so it's very risky.

[Anonymous]

I was unexplained at the first clinic I went to. Before spending thousands on IVF I went to another and the work up was much more intense and invasive, but my doctor immediately found the problem and I got pregnant without needing IVF. There’s really no such thing as “unexplained” fertility - it’s just unknown to the doctor at the time. Personally I would demand more tests and answers or find another doctor.

[Anonymous]

I would test the embryos

[Anonymous]

Anonymous wrote:I was unexplained at the first clinic I went to. Before spending thousands on IVF I went to another and the work up was much more intense and invasive, but my doctor immediately found the problem and I got pregnant without needing IVF. There’s really no such thing as “unexplained” fertility - it’s just unknown to the doctor at the time. Personally I would demand more tests and answers or find another doctor.

OP here - What intense/invasive tests helped you discover your diagnosis? I’ve been to two different clinics plus my OBGYN and we had several tests done multiple times. We haven’t done karotyping or an ERA yet. Since I suspect endo, the next step to confirm it would be an exploratory laparoscopy since HSG was normal. We are exploring this but insurance won’t cover it yet and the RE wants to try a few more FETs.

[Anonymous]

I had endometriosis that wasn't diagnosed for years. Lupron worked before my transfer. Try receptiva, especially since you suspect endometrosis. I was told that I did not have endo for years, my receptiva came back positive, and lupron before the transfer. It worked. It's super contraversial and many REs don't believe in it.

I always transfered two embryos, even when I was much younger than you. Many of them did not work. Transfering two is definitely not a guarentee for twins and I've had REs both in this area and in other states that recommended transfering two.

[Anonymous]

My first two medicated FETs ended like yours, with a positive FRER that got progressively fainter. My doctor tried putting me on an extra day of progesterone, and the three FETs that followed have all been successful. I don’t remember her reasoning, but that approach might be worth discussing with your clinic?

I was 33 at egg retrieval (all five embryos were 5-days from that same “batch”) and did IVF due to male factor, for what that’s worth. We did not test any of the embryos, so it’s also possible that the first two weren’t viable to begin with. I considered transferring two after the first loss but did not want the increased risk of twins. Good luck!

[Anonymous]

Anonymous wrote:My first two medicated FETs ended like yours, with a positive FRER that got progressively fainter. My doctor tried putting me on an extra day of progesterone, and the three FETs that followed have all been successful. I don’t remember her reasoning, but that approach might be worth discussing with your clinic?

I was 33 at egg retrieval (all five embryos were 5-days from that same “batch”) and did IVF due to male factor, for what that’s worth. We did not test any of the embryos, so it’s also possible that the first two weren’t viable to begin with. I considered transferring two after the first loss but did not want the increased risk of twins. Good luck!

Thank you! I'll ask about the extra day and lupron.